Your longtime pals know all your best stories, what you'll order when you eat together at the place you always go and how you feel about your relatives, current events and exercise classes on Zoom. Make new friends, and whole new worlds open — and that's good for you.
"We've all just gone through an unwanted national experiment on social isolation, and there's no better time than the present for increasing your social circle," said Dr. Eric Lenze, a geriatric psychiatrist and psychiatry professor at Washington University School of Medicine in St. Louis.
His research, funded by the National Institutes of Health, explores the effects of stress and social isolation on older adults and the benefits of social activities for increasing resilience.
"Older adults who report a higher level of social support have better emotional health, physical health and brain health, plus they have better cognitive functioning over time," Lenze said. "Initially, many older adults proved quite resilient at sheltering in place. But as it went along, it started to take a toll on mental and physical health."
"We've all just gone through an unwanted national experiment on social isolation, and there's no better time than the present for increasing your social circle." 
That may be especially true for "solo agers." Some 27% of adults 60 and older in the U.S. live alone, and it's particularly important for these individuals to stay connected.
To ramp up social interactions, Lenze recommends all older adults get vaccinated against COVID-19 right away and then follow these steps:
Write down any social networks you gave up during the pandemic and start reconnecting.Consider what you do online, including scheduling grocery deliveries, and go back to doing some of the activities in person.Think about all things you wished you could have done during the pandemic and start filling your schedule.That last recommendation is known in psychology as "pleasant-events scheduling," and Lenze said it is one of the most effective treatments for depression.
"Fill up your calendar, even with things you never did before," he said. "There's nothing about aging that suggests you can't try new things."
More 'Intentionality' Is Required 
Increasing your social interactions requires a deliberative effort, and Margit Novack, of Philadelphia, and the author of "Squint: Revisioning the Second Half of Life," understands that. 
In response to our question on the Next Avenue Community Facebook page, she wrote, "Developing friends as an older woman requires more intentionality. When I was raising kids or at work, friendships developed naturally. Now, if I want deeper relationships than acquaintances, I need to create space/opportunity for that to happen."
Conventional wisdom suggests that we'll find new friends by joining a book club or knitting group — or starting one. Others choose to volunteer at a food bank, work on a political campaign or sign up for docent training at a museum or zoo. 
"You get a two-fer if you join an exercise or yoga class or a meditation group because you get the physical and mental benefits of the activity plus the socialization," Lenze said. "Going to a dance class is a three-fer, because that's also cognitively stimulating." 
When you move to a new city or town, opportunities immediately arise for making new friends. When Ginny Burch Reed moved from New Hampshire to Vermont, she found lots of opportunities to volunteer for local organizations. "For a person who isn't particularly 'social,'" she said, "I seem to be involved in quite a few activities and have met a lot of terrific folks."
Jana L Hill relocated from Washington, D.C. to Belize, where she quickly found like-minded people. Every Saturday, Hill and a half dozen other individuals walk the pups living in animal shelters.
The Value of Younger Friends 
Charlotte Japp, a 2020 Next Avenue Influencer in Aging, makes a case for welcoming younger people into your inner circle. Japp is the founder of CIRKEL, a platform that connects workers ages 20 through 70+.
"More and more, we are siloed by age, and there are career and social consequences to that," Japp said. "We all go through very nuanced abstract experiences and it's good to talk to someone who has a different perspective. Life is so enriched by diversity, in every sense."
Kim Coryat, 65, agrees. "Several of my best friends are younger than my daughter, and socializing with them keeps me up on pop culture, current fashion and music," she said.
"I give thanks for several younger adults as friends as I enter retirement." 
One of her best friends is 30 years her junior, and Coryat, who lives in Conway, Ark., takes vacations with a 75-year-old friend and the woman's 55-year-old daughter. Coryat retired early in 2020 from her job as an archivist at the William J. Clinton Presidential Library in Little Rock, Ark.
"I trained for that job with people thirty years younger than I was, and I didn't feel generational barriers," Coryat said. "Maybe that's because I went to college late, too. I didn't start until I was forty, after I retired from the military."
Coryat noted that she easily blended in with a younger crowd then because she didn't look her age. "Also, I was open to learning new things, going out to clubs and singing karaoke," she said. "I even joined a boot camp exercise program, where I learned as a woman of a certain age that jumping up and down was not my strong suit."
Find 'New Horizons'
Hart Edmonds, a Presbyterian pastor who lives in Hillsborough, N.C., also responded to our query on the Next Avenue Community Facebook page. "I give thanks for several younger adults as friends as I enter retirement," he wrote. "As a minister, I've been privileged to work with and learn from younger people who I find yearning for mentors and friendship with older adults. Too often our culture segments people by age and stage of life."
Anne Crowley also appreciates her younger friends, "for the energy they have and for reminding me it's important to have hope and keep working to make this world a better place."
Crowley, based in Washington, D.C., added that she has expanded her circle by starting a group for women "in or approaching midlife who want to make these years the best of their lives" and "by seeing a lot of live music and being friendly to people I meet at shows."
Steve Trickler of Scottsbluff, Neb., is in his 60s, and he's noticed many people his age are starting to slow down. "Maintaining ties with my younger friends allows me to stay more active," he wrote. "Plus, they are more adventuresome, more willing to try new things, go places. They are more in tune with literature and music — all of which excites me and keeps me enthused. Staying young at heart is about challenging yourself and finding new horizons to excite you and energize you."
Making new friends may help you do just that.


Looking for a Healthy Boost? Make New Friends.

Patricia Corrigan

I'd been living on luck for years before I signed up for hospice.
I'm 80 years old with multiple health problems, including lung cancer and COPD. I live alone, my only relative a daughter 1500 miles away. I have friends, but they are also older and I am loathe to bother them in an emergency. I don't have a life alarm button. If I fall, I'm on my own.
"The word "hospice" conjures up a vision of imminent death. And for many people, this is the case. They are so anxious to avoid facing their own mortality that they don't apply for hospice until the grim reaper is at the door."Last October I wound up in the hospital with severe pneumonia — after a terrifying episode of what the doctors called "respiratory failure," which means I couldn't breathe. I had the presence of mind to call my "young" friend Angela (she's in her sixties) who lives nearby and was kind enough to come over and call 911. 
I had already decided to forgo any more drugs for cancer since they were worse than the disease — which made me a candidate for hospice.
She accompanied me to the local hospital where I spent a hellish week, possibly the most harrowing experience of my life. It freaked me out and forced me to reconsider my options. I knew I had to do something to avoid another 911 call in the middle of the night — but what? I couldn't afford a live-in aide, I couldn't depend on Angela and I sure didn't want to wind up in a nursing home.
As I usually do, I put off a decision. But a few months ago, I had an episode of terrible chest pain. I mean excruciating. It came out of nowhere and felt like a vise was being tightened above my breast area. I was determined not to call 911. I took a chance. I assumed it wasn't a heart attack, popped a few oxycodone that I'd stashed away after a recent back surgery and went to sleep. I was sore in the morning but alive. I guess I had pulled a muscle.
A Wake-up Call 
But that was my wake-up call. I knew there had to be another way. I had been on "targeted therapy" for cancer on and off for years, but the price was steep: constant fatigue, diarrhea, skin infections, loss of appetite and vocal cord nodules. I had already decided to forgo any more drugs for cancer since they were worse than the disease — which made me a candidate for hospice.
I had reached a point in my life where quality of life trumped quantity. I wanted to be able to enjoy whatever time I had left.
If you have a terminal disease and are not pursuing curative treatment, you can go on hospice with a doctor's referral. My cancer center's palliative care team was only too happy to refer me.   
Some people stay on hospice for years. They can go off hospice if they decide to pursue curative treatment.
Despite the negative bias towards being on hospice, I decided to go for it. I've never been one to pass up free services. There is an assumption that you have to have less than six months to live to be accepted to hospice, but that's just a ballpark. The official criteria: "your doctor and the hospice medical director certify that you are terminally ill and probably have less than six months to live."
"Probably" is the operative word. No one can predict how long anyone will live. Some people stay on hospice for years. They can go off hospice if they decide to pursue curative treatment.
The Timing of Hospice 
The word "hospice" conjures up a vision of imminent death. And for most people, this is the case. They are so anxious to avoid facing their own mortality that they don't apply for hospice until the grim reaper is at the door. Then hospice has to hustle to help them and often doesn't have the time to coordinate adequate services. That's the worst mistake people make when it comes to hospice, waiting too long to apply.
I'm not in denial about my situation — I've always been a realist.
My hospice nurse, Nickole, whom I consider my personal angel, explains: "When a patient comes on early enough, the interdisciplinary team has a chance to know the patient and their goals for care, we have a better chance of making them comfortable and reconciling any issues that need to be taken care of."
She continues, "You're able to get care in your own home knowing that should there be changes at any time, you have a team available to you where we can keep you comfortable so you don't have to go back and forth to the hospital. When a patient waits until the last minute when they're actively dying, we don't have enough time to get them comfortable."
That's what happened to my friend Lonnie, who died from cancer, but went through agony because she was in denial about her imminent death and refused to call hospice until the last possible moment. 
I'm not in denial about my situation — I've always been a realist. I discovered hospice offered the very services I needed most. A nurse on call 24/7. Help in a crisis. All my meds delivered to my door. If I have an emergency in the middle of the night, a medical professional will show up. No ambulances, no emergency rooms, no admission to a medical system that is uncaring and incompetent. 
The Help I Need 
Whew! Bring it on. Hospice will even have a nurse stay with me in my home for few days if needed. They also have an in-patient facility where you can stay temporarily if you're having a health crisis or are close to death and don't have a caregiver at home. Most of all, hospice gave me peace of mind.
As you probably know by now if you're old enough to worry about your options for the future, the long-term care options for older adults on Medicare in this country are dreadful, I think. It's a nursing home or nothing. 
So yes, I love hospice. Especially Nickole who visits every week and brings some sunshine — and often home cooked lasagna — into my life.
Unless you have long-term care insurance, which most of us don't (too expensive) you have to hire your own home health aides — a very costly proposition. I do have someone 4 hours a week but she's not a medical professional — she mostly cleans and shops for me. You can get an aide from Medicaid, but coverage and eligibility varies. 
There may be local help you're entitled to, but good luck finding it. I tried to track down the right agency myself but got nowhere. My hospice social worker knew who to call. She actually stayed on hold for a half hour — at my house — until someone answered and made an appointment for me. I'm now on track to get some extra help.
So yes, I love hospice. Especially Nickole who visits every week and brings some sunshine — and often home-cooked lasagna — into my life. I've been told not all hospice nurses are so adorable. I just got lucky.
So far, I'm doing OK. I'm on oxygen sometimes, but I still go out to dinner, to my book club and shop for my own food sometimes. Unlike many hospice patients I don't have dementia. Nickole tells me I'm one of a very small percentage of her patients who are compos mentis (have control of one's mind). 
Maybe, like Malachy McCourt, I'll be kicked out of hospice for not dying fast enough. Or maybe they'll see me through till the end. Either way I'm OK with it.


Opinion: Why I Went on Hospice Even Though I'm Not Dying

Erica Manfred

For Beth (not her real name) living alone is a good thing. Over the years, she has grown accustomed to the single lifestyle. She's satisfied with doing things on her own, even to take long bike rides. Just the other day, the cool weather motivated Beth to do exactly that — jump on the bicycle for a ride.
But this ride was different. As she glided down the driveway, and turned onto a busy street, nothing could have prepared her for what was about to happen A few miles away from home, from nowhere, an eighteen-wheeler skirted a little too close, blowing Beth off balance. Stunned, she jerked the bike a bit too hard which sent her hurling over the handlebars, crashing on her hip. She stayed there until the ambulance showed up.
If you land in the hospital, who could step in and do what needs to be done?In the ER, the doctor reported: "Broken hip, you'll be in rehab awhile. Who should we call?"
Having a trusted friend, family member or professional to call or text as an emergency contact should be the top priority when compiling confidants for medical records, important documents and smartphones. The designation is I.C.E.: In Case of Emergency contact. And it should be labeled as such. Perhaps you rely on a close friend or family. But if you have no one nearby, you're stuck.  
"To feel secure and connected, develop a team of people who can support you." 
In 2019, the Institute of Healthcare Policy and Innovation claimed 22% of the 50 to 80 age group had an emergency or disaster such as a power outage lasting more than a day, severe weather, evacuation or lockdown, while 73% reported experiencing at least one such event during their lifetime.
Although more than half of older adults believe they will experience some type of crisis, the majority feel confident in their ability to manage. And when living alone, it's critical to prepare and develop a support network of friends. 
Build a Network of Support for Emergencies
Create a group of people for social interactions and relationships, as well as a group that will look out for one another. What's important is that you're comfortable with one another and you actively participate in the relationships. If you enjoy their company and conversation, they are part of your network.
Alison Arnett, geriatric care manager at PremierCMGA in Atlanta, suggests developing a purpose-driven network. "No one lives alone — there are people all around. To feel secure and connected, develop a team of people who can support you," she says. "Many times, people are stuck because they have no one to look out for their welfare."
Where To Find People to Support You 
Make a list of activities and groups that give the opportunities to engage with people: Political, religious, sports, social or hobbiesVisit local senior centers, public libraries and volunteerGet to know your neighborsTeach a hobby and a skill that you excel in at the local community college or lifelong learning instituteCall the Area Agency on Aging for a list of active adults’ groupsContact local NCOA active aging programsCaryn Issacs of New York, a patient advocate with GetHealthHelp.com, advises, "When selecting people to care for you in time of need, pick those who know your preferences, and who are strong enough to lift things like shopping bags and even walkers. It's vital they know how to access transportation and other services. It's better if they're active listeners and efficient note takers. And you must trust them."
Here are several types of emergencies you should prepare for: 
Power Outages
For a power outage lasting over 24 hours, two in three older adults felt very confident that they were prepared, 27% were somewhat confident, and only 4% were not confident at all, according to the Institute of Healthcare Policy and Innovation.
In July, my high rise building in Texas lost power for 17 hours. The temperature hit 100 degrees outside. The outage was not city wide; however, a year earlier during a winter storm, power failed throughout the metroplex. From that, I learned to be better prepared.
Arnett suggests, "Learn the locations of the city-sponsored shelters in case of lost power and situations like a snowmageddon." People need to know where to go and have a plan to get there in case of a weather-related crisis. Finding shelter is critical. Visit a Disaster Recovery Center (DRC) to receive guidance or information. Additionally, make sure to know when to evacuate an area.
Assemble a Power Outage Emergency Kit
Meals, snacks and water for up to two weeksStyrofoam coolers for food storageFlashlights, lanterns and candlesExtra batteriesBattery operated laptop, cell phone charger, radio and fanCash on handRead the full guide at Ready.gov to learn what’s needed in a power outage planMedical Emergencies
No one expects to slice one's finger while preparing food, which I experienced. When it happened, there were neighbors who I knew could help out. I grabbed a towel, wrapped the finger and walked down the hall to a friend's apartment.   
And if the crisis is more traumatic than a cut finger like a bicycle accident or a broken hip, Nancy Ruffner, a patient advocate in North Carolina, encourages third-person thinking which removes you from the situation. If you land in the hospital, who could step in and do what needs to be done?
"When making a plan, remove the emotions and focus on the tasks — who could get mail/find or assemble bills and pay them? Who will watch your home; water plants, check for security, turn lights off and on, move things around outside to create the appearance of someone there?" says Ruffner. "If you have a pet, who will care for it?"
"When making a plan, remove the emotions and focus on the tasks"
Be Prepared 
Have a hospital go-to bag filled and ready to grab. Include an I.C.E. list (in case of emergency contact list) of medications and medical conditions, a photocopy of a health insurance card, Medicare card (black out the last four digits of the Social Security number,) toiletries, pen and notebook, puzzle books, lip balm, hand sanitizer, personal grooming items, a copy of the Healthcare Power of Attorney documents. Identify a key contact person. Make an extra copy of the contents of each folder and leave it with a friend or relative at home.
Create a spreadsheet listing your support contacts and information such as who will look after your home, pet, vehicle, food in the refrigerator, etc. Also list who will check on you in the hospital, gather necessities and bring them to you. 
Make sure you have a first aid kit and emergency supply kit on hand at all times. Additionally, know how to recognize a medical emergency.
Weather Emergencies
Extreme Cold
Mountain regions aren't the only areas affected by winter storms. Even low altitude regions get hit. Blankets of snow snarls traffic and keep people indoors. In 2016, winter storm Jonas crushed the Northeast with up to 31 inches of snow.  
During winter storms, the priority is staying warm and safe. Here are some tips for planning ahead:
Cold Weather Emergency Kit
Home: Keep the cold out with insulation, caulking and weather stripping. Keep pipes from freezing. Install and test smoke alarms and carbon monoxide detectors with battery backups. Install storm or thermal-pane windows or cover windows with plastic from the inside. If you're without power, have a power outage emergency kit on hand.
Car: jumper cables, sand, flashlight, warm clothes, blankets, bottled water and non-perishable snacks. Keep a full tank. Ready.gov offers a full guide for car preparation. 
Hurricane, Tornadoes, and Floods
As has been observed recently in the wake of Hurricane Ian in Florida and the Carolinas, it's important to be prepared for an emergency, knowing that internet access could be impacted by major storms. Ready.gov offers options for emergency messages from authorized federal, state, local, tribal and territorial public alerting authorities that broadcast warnings. 
Be Wary of Disaster Related Scams 
Colleen Tressler, Bureau of Consumer Protection, Federal Trade Commission, warns, "In addition to preparing for weather disasters, protect yourself from scammers.  These criminals use emergencies to cheat consumers." 
Clean-up and repair scams — Ask for IDs, licenses, proof of insurance, and references. Ask friends for referrals. Put all promises in writing and understand what you’re signing. Never pay cash or full payment until the work is done and you’re satisfied.Imposter scams — Ask for IDs. If they ask for money or a bank account or credit card number, it’s a scam.Job scams — be alertBe wise to rental listing scamsBe alert, stay safe, and prepare for emergencies. Do it now before you're taken by surprise and build a support team of nearby peers and friends.
Additional Emergency Resources for Solo Agers
Emergency Preparedness for Older Adults (cdc.gov)
Older Adults Emergency Preparedness | American Red Cross
6 Tips on How Older Adults Can Prepare for a Disaster | National Institute on Aging (nih.gov)
Seniors – Prepare Now for an Emergency | FEMA.gov
Seniors | Ready.gov
Prepare For Emergencies Now: Information For Older Americans. (ready.gov)


Emergency Planning for Solo Agers

Carol Marak

What does it mean to be a solo ager? There are currently 12 million of us in the United States who are single by choice, live without a spouse or partner; many are widowed or divorced. We may never have had children or are estranged from them.
In this collection of Next Avenue stories, experts offer personal advice and resources for navigating social, emotional and practical topics that solo agers may want to consider.
For instance, how do you develop or strengthen your safety net of key individuals to help you grow older?
How do you prepare for the rest of your life in terms of health care needs, housing, financial wellbeing, end-of-life directives and estate planning?
In a world that became more isolated in the pandemic, how can you find meaningful connections with others when your options are limited?
And how can you grow your personal networks and engage with others in ways that feel comfortable and accessible? Where can you turn for help with questions about important decisions to ensure yout own best interests?
We've also curated a series of essential guides, planning checklists and specially designed email courses to help you get concrete plans in place. Get started now so you can enjoy the peace of mind we all seek as we look to the future.


How to Thrive as a Solo Ager

In this last week of 2022, we are featuring some of our most popular stories of the year. This piece was originally published in January. Planning for the long-term can be unsettling, because aging is complicated and stacked with complexities and risks. But if you are a solo ager - someone without a spouse or children - enacting a plan will, over time, turn out to be one of the smartest things to do. Starting out, the toughest question to address is, where do I begin? That in itself elevates one's stress and worry to the point that it causes people to delay or put off making a plan entirely.  
In the book, "The Mayo Clinic Guide to Stress-Free Living," Dr. Amit Sood, a Mayo Clinic specialist in stress and resiliency, reveals how the mind's instinctive restlessness and shortsightedness generate stress and anxiety — especially when under pressure to perform.
When in this state, the brain reverts to distractions and absent-mindedness and Sood believes people spend half or more of their days disengaged from the present moment. And if you're dealing with a particular event or an emergency, being disengaged and absent-minded is not where you want your brain to be during the times that require unwavering decisions. 
Since the caregiving experience illustrated to me the biggest challenges that I will encounter at some point, helping my parents turned out to be a wake-up call. The idea of managing my life in the older years without daughters or sons to rely on invited much worry and stress.
Working through the worries of aging alone, over time I concluded, Wouldn't it make sense to think through significant long-term concerns before these issues become a threat?  
Eventually, that's what happened, and I got to work. I reviewed the top concerns that my parents faced and laid out a plan — a strategy that strengthened my ability to achieve independence in my 70s, 80s, and 90s.
I'm happy to report that applying these action steps has netted a higher confidence in my ability to take better care of myself and to live independently far longer. And if you apply them in your own life, I bet it will do the same for you.
A Solo Ager's Toolkit for Independence
Instinctively, I knew that ill health and other aspects such as isolation and loneliness, having purpose, and lack of support would agitate my wellness and stability.
Most singles and adults aging alone give little regard to the risks until they have firsthand experiences. If you've ever been or are currently in the throes of elder care, you can relate. That's why it is imperative to learn healthy, connected, and supportive behaviors long before you need help. 
The Guided Roadmap for a Supportive and Secure Future is a strategy that launched my own future plan. The circle came about from observing my parents. The tool opened a window to assess life's domains and the opportunity to witness where I fall short and where I excel.
Once I had a solid handle on my strengths and weaknesses of these top aging issues, I was primed for the needed changes.
The Living Well Assessment
The Living Well Assessment illustrates and instructs a person how to assess, evaluate and rate their current level of satisfaction in each domain: Money/Finances, Spirituality, Work/Purpose, Legal, Fun/Engagement, Community Support, Transportation, Family/Friends, Health/Fitness and Housing/Location.
Using a set of questions per domain allows a user to self-appraise each by giving it a value on the scale from 1 to 10, with 1 being a "difficulty or complete dilemma" and 10 is "wow, this feels good, minor improvement needed." 
After giving each question an honest value ranging from 1-10, tally up the final result by adding each value within the domain sequence. It sets the stage for identifying where you are right now with each. 
Knowing which domain receives the fewest tallies, signals the need for attention, adjustment, and reform.
Let's get started! Please know this is a condensed version of the Living Well Assessment. Answer each question and give it a rating 1-10. Keep track and tally the final result by adding each value within the domain sequence.
How Satisfied Are You With Your Health? 
Knowledge about your family medical history?Number of, and how well you manage, your chronic illnesses?Annual blood test results and screenings?Daily nutrition and whole foods intake?Your self-care routines?Ask: Do I have any chronic diseases, and how can I improve managing them? For relatives who have died, what can I learn about the cause and age of death? What would "healthy"look like for me? What are my barriers to good health: diet, nutrition, and exercise? What decisions can I make today that positively affect my health?
How Satisfied Are You With Your Housing? 
Ability to pay the home mortgage or rent? Can you easily handle the maintenance costs and upkeep?Home’s ability to meet your age in place requirements? Is it a single home or two-story?Proximity to family and friends, doctors, pharmacies, other medical facilities, shopping, senior centers, religious facilities, and other amenities?In­-home support services when needed?How Satisfied Are You With Social Connections? 
Your daily social interactions and activities?The available support?Loneliness and isolation?Social network size?Ask: How can I enhance connections where I live? What could happen that would enable me to feel fully engaged? What kind of friendships do I want? Describe them. What's one thing I can do to improve connections and friendships? What are two things I can do this week to feel less lonely? At times that I had the most friendships, what was going on?
How Satisfied Are You With Support? 
If you wanted to go on a trip for a day, or have lunch out, is there someone to invite?Who can you talk to about private worries and fears? What about financial and medical decisions?If you were sick, can you easily find someone to help with daily chores?Is there someone you can turn to for advice about handling problems?Ask: What is the biggest barrier for having support? What types of support would satisfy my needs? What are my local options? Who isn't available to help? Why not? Too costly? How can I create a support network offering reciprocity? 
How Satisfied Are You With Your Location? 
Level of police monitoring where I live?The safety and crime rate?Are health services nearby? What about shopping?Are recreation and cultural activities nearby?Ask: How high is the crime rate? What are the options for free alerts about recent crimes near me? What are the alternatives for remaining in the community as I age? What kinds of health medical services are available? What kinds of jobs exist? Does shopping require driving?
How Satisfied Are You With Exercise and Fitness? 
Sit to stand position?How many pounds can I lift and carry?Can I sit and reach? Sit to stand and go?How far can I walk?Moving my body? Ask: When active, what kind of things do I enjoy? How can I move more during the day? How has my energy level changed? What do I enjoy about (insert activity, such as walking in the park)? How does my body feel when I'm active? During? After? How does being active influence my mood?
How Satisfied Are You With Transportation? 
Driving a car or in heavy traffic?Affording a vehicle?Having easy access to medical rides or getting to appointments?Walking to shops and getting groceries?Ask: Are there private or non-profit transportation services? Public transit nearby? Can I walk to do errands?  Do medical/transportation services exist? Are friends or family available for rides or help with errands? What other transportation options are available?
How Satisfied Are You With Your Finances and Legal Matters?
Retirement savings?Amount of debt carried?Amount of an emergency fund saved?All the assets?Checking and savings? Overseeing my finances if I can’t?The selected health and financial proxy? My will or trust? Find Solutions and Take Action 
Your goal, once you've assessed your life and needs: Find solutions by understanding what actions you need to take to improve the issues that rate 5 or lower. Then locate solutions that appeal to your preferences through research. This is an abridged version of the Living Well Assessment however, it's a great place to start. By doing the work, it sets your life on the trajectory of aging well.


For Solo Agers, A Roadmap for a Secure Future

The role that a robust, age-diverse support system plays for a solo ager (an aging adult 55+ single or partnered, who is without the support of adult children or close family members) is critical.
Third places are locations where we exchange ideas, have a good time, and build relationships. They are comfortable spaces and accessible to everyoneConnection to others is extremely important as one navigates their own health, the complexities of the health care system as a whole, and residential, financial and legal decisions. For solo agers, identifying personal contacts and qualified professionals to serve in these key roles that are "traditionally" filled by adult children/relatives requires careful and intentional planning.
It is equally important to be intentional about one's social support and connections. Where one lives and what access there is to community services and support is an important consideration. It is not always on people's checklists when researching the topic of community and housing as one ages, but it should be.
Connecting with others assists with improving our self-esteem, feeling cared for, reducing stress and increasing our resilience. 
Being part of and connected to a community has a major impact on our health and personal satisfaction. Connecting with others assists with improving our self-esteem, feeling cared for, reducing stress and increasing our resilience.
While Oldenburg's research focused on physical locations, it has become clear throughout our time navigating the pandemic that "virtual" places can play a role in our connection to others and to the community at large.
As one ages, meeting new people becomes more difficult. After retirement, there is no longer the ease of making new connections via a work environment, and for solo agers, there are not additional connections available via the friends of children or grandchildren. Yet, social support is critical to all aspects of our lives.
In my work with solo agers, I am often asked, "How do I make new connections?" and "Where can I meet new people?"
While it can be difficult to meet new people as we age, we often overlook the impact of our connection to "third places," which can offer new opportunities to expand and enhance our support systems.
What Are Third Places? 
"Third places" is a term coined by urban sociologist Ray Oldenburg and refers to places where people spend time between home ("first" place) and work ("second" place). They are locations where we exchange ideas, have a good time, and build relationships. They are comfortable spaces and accessible to everyone.
Third places are a part of our daily life and community and we connect to them in a variety of ways. Some are free or low cost — parks, libraries, community and senior centers, faith communities, adult education and other classes, and volunteer organizations. Others are commercial establishments like restaurants, coffee shops and bookstores. They can also be places that offer personal services such as salons, barbershops and gyms.
These connections and opportunities are not only a helpful adaptation as a result of the pandemic, but offer greater access and connection to those who are unable to travel for mobility or other reasons. The ability to attend a talk, meeting, book club, class or social gathering via video chat furthers our connection to others.
How to Make New Connections
Being connected socially to others offers a greater sense of purpose. It also lowers cardiovascular risks, including lowering blood pressure, motivates you to engage in a healthy lifestyle and encourages medication and treatment adherence.
To explore where there might be opportunities to make new connections consider:
Do I have a daily routine? Where do I go and who do I encounter? Who do I see/speak to every day?Do I have a weekly routine? Who do I see/speak to once per week?Do I have a monthly routine? Who do I see/speak to monthly?Am I a member of an “in person” group/groups?Book club, cards, Mah Jongg, current events, meditation, knitting, photography, walking, classes, birdingAm I a member of an online community or group/groups?Book club, current events, classes, faith community, professionalStop into a local bookstore and review what talks and programs they offer. Meet a friend for coffee somewhere new. 
Once you have given thought to what might be available to you, explore your interests. (Presuming it is healthy to do so.) Stop into a local bookstore and review what talks and programs they offer. Meet a friend for coffee somewhere new.
Make a list of things you would like to try and find ways to make it happen. Enroll in a course at an area university/college or your community adult education program. Take an art or writing class. Volunteer and meet others with similar interests. Join a book or photography club. 
In my experience as an independent board-certified patient advocate, and solo aging advocate and educator, the concern over a limited support system often weighs on the minds of solo agers.
Approaching the spaces and "third places" you connect with daily, weekly and monthly in a different way and with new perspective can offer new opportunities and enhance your social network.   


The Impact of Third Places for Solo Agers

Ailene Gerhardt

I am euphemistically known as a "solo ager," a 66-year-old child-free widower with no plans to seek another primary intimate monogamous relationship. I must admit that the term "solo ager" is preferable to the horrible designation made by other social scientists who refer to me as an "elder orphan." That phrase reeks of an aging Oliver Twist, developmentally frozen in the pain of abandonment and fear.
I am certainly not orphaned. I am well loved by others, continue to be involved as a psychologist in meaningful professional work and live independently. I feel vital in my activities of daily living and am as busy as I want. That said, it is a truth that I am existentially and observably alone as I live into this stage of life. This alone-ness carries unique risks for those in my cohort.
It's Challenging for Men to Be Vulnerable
A good deal of consideration is currently being given to solo aging. Themes abound for connecting to others and making personal wishes, including legal and financial directives, formal and concrete. While good advice, much of it tends to go in one eye and out the other as I, and many men of my generation, view such guidelines through a traditional male lens. 
Most of us are feeling lonelier and more isolated than we care to admit. 
Men of my ilk were taught from an early age never to admit vulnerability or to ask for help. So, we don't. 
We were taught to figure out problems independently or be humiliated:
Am I sick? "If I'm not feeling better tomorrow, I'll go to urgent care."
Am I lost? "I can't be far from where I'm going. I don't need the GPS. Let me try this turn." 
Do I need help carrying my groceries to the car? "It's just a sprained ankle. I can get this."Am I lonesome?  "I'm fine. I'm fine." 
As men, we would rather stand naked in rush hour traffic than risk the exposure of not knowing, or worse, being seen as weak and culpable for perceived fragility.
This type of traditional masculine maneuvering is potentially dangerous territory, particularly on the heels of the pandemic.
Most of us are feeling lonelier and more isolated than we are willing to admit. Our support systems have been disrupted, our health challenged and any sense of a normative rhythm upended in ways unknown during our lifetimes.
Fortunately, there are social science directives, translated here in masculine frames of reference, that may be helpful to mitigate the challenges of going it alone.
3 Steps for Successful Solo Aging
1. While You Are Healthy, Make Plans.
Complete advance directives and designate a trusted health care proxy. Spell out personal wishes regarding medical treatment. Grant someone the power of attorney to handle legal and financial matters should the need arise. Inform those close to you about your designate to ensure as little misunderstanding as possible in the event of a crisis or emergency.
Talk to an elder care financial planner. A 2020 study from Northwestern Mutual reports that "Overall, single men and women are generally less satisfied with their financial circumstances than married Americans. More than four in ten single men and half of single women say they feel either a moderate or a high level of anxiety about their personal financial security." 
Rely on the professional to assist in formulating a reasonable plan for managing money and financial resources, including considerations for long-term care, however that might emerge.
2. Go Toward Others.
Social science tells us there is great benefit in being social as we age. The impact of social distancing during the pandemic will be studied for years to come. Already, there is sound determination that the loss of broad interpersonal communities has undermined our collective sense of security and anchoring to day-to-day living. 
The psychologist John Cacioppo, in his 2009 book "Loneliness: Human Nature and the Need for Social Connection," reports that loneliness may have twice the impact on early death as obesity and is as damaging as disadvantaged socioeconomic status.
We men are notorious for waiting for others to contact and recruit us into social activities. Such a stance never, never, never works.
Perhaps that statement is unclear and bears repetition: Waiting for others never, never, never works. 
When lonesome, sitting and waiting for others' invitations breeds disappointment, isolation, cynicism and contempt. Social connection requires reaching out and intentionally moving toward desirable activities and people. When activities are fun and meaningful, most in the gathered group will be equally engaged, making for easier collegiality and companionship.
Perhaps that statement is unclear and bears repetition: Waiting for others never, never, never works. 
A male solo ager is entirely responsible for his social life. Guys must be friendly to have friends.  This truth is easier for those, like me, who are extroverts. For those who are introverts, think carefully about living choices. Living alone in a family home may require an increased amount of solitary upkeep.
If there are adult children, remember they have their own urgent lives and may not be able to attend to elders with the frequency or intensity that a solo aging parent expects.
There are contemporary options for living at this stage of life, including 55-plus or retirement communities, walkable communities if driving is a challenge and village-to-village networks , which are grassroots organizations formed through a cadre of caring neighbors who want to change the paradigm of aging. Local villages connect members to a full range of practical support services to help with non-medical household tasks, services, programs, and transportation.
3. Get Busy. Stay Physically Active.
A major contributor to isolation and adverse aging is found in the loss of a schedule. Particularly for men, we rely on the identity that work provides. Typically, we are known for what we do. Our work identity provides meaning and accountability.
After retirement, there are new personal definitions to enhance our sense of self as we age. We shift into being known for who we are. This "hard right turn" from what we do to who we are is enhanced by routine rhythms of planned activities which contribute to ordinary vitality. Add regular physical activity and stay in motion. Research confirms that when physical exercise and social activities are combined, overall psychological health is amplified.
Looking ahead, allowing room for help, and seeking the companionship of others are keys to going it alone with integrity. Does it solve all the loneliness encountered as a solo ager? Certainly not, but it does keep us in in charge of what is manageable as we grow older.


How Men Adapt to Being Solo Agers

Jackson Rainer

This essay is part of Telling Our Stories: Reflections on the Pandemic. We invited readers to share their experiences of the past year, and selected 12 essays for publication on Next Avenue. Read the full collection.When we first went into lockdown, I remember the fear in people's voices as we grappled with our sudden loss of freedom and the anxiety about the possibility of losing loved ones.  Gradually, my own fear was replaced with monotony, punctuated with minor inconveniences. 
I'm 62, still employed as a civil servant, and I live alone. Masking, handwashing and sanitizing have become stylized rituals, easily reversed. If anything has changed permanently, it's my perspective on my own social life. 
In the before times, regular interactions with coworkers, neighbors, friends and a few relatives kept me from feeling the sting of loneliness. I scoffed at occasional allusions to my being perhaps a just a bit too self-reliant. 
I like my own company and although I don't advertise it, I often look forward to long weekends and holidays to satisfy my introverted need for battery recharging. But even for me, a year of alone time has been a challenge.
Without the noise of the usual hubbub to distract me, I've become painfully aware, and frankly terrified, of how thin and fragile my social network really is. 
I've learned how important even the people you don't know well can become when there's a crisis.  Just noticing one of the regulars in my landscape can give me a boost, like the kid down the block who works at a costume store. 
For several years, I've occasionally caught sight of him standing beside his car, smoking a last cigarette before he heads to work, dressed as a different character each time (a chicken, a vampire). I used to shake my head with embarrassment for him. Now I feel oddly sympathetic and also reassured that there's still some normalcy in the world because he apparently hasn't lost his job. 
Or that young woman who moved into the unit at the end of the hall whom I used to regard as a nuisance, with her silly invitations to join her for a margarita on Friday afternoons. Her kindness has been a lifeline for me this past year.
Without the noise of the usual hubbub to distract me, I've become painfully aware, and frankly, terrified, of how thin and fragile my social network really is. I depend too much on too few people. I catch myself trying to forecast what it will be like when my job is in the rearview, more family pass away and friends move to be close to their children. 
Will my life become like an endless weekend of watching TV, reading, emailing, an occasional Zoom call, home projects…kind of like, um, now?  
As I write this — knock on wood — I've been able to make necessary adjustments to keep my life working and no one close to me has gotten sick or lost their job. Even luckier may be this unpleasant preview of retirement.  
Thanks to the pandemic, I've found my next mission, which is to build some redundancy into my support system, starting NOW. I hope my next submission will be about that process and how I'm succeeding in saving my own life. 


The Pandemic: A Preview of Retirement?

Cindy Andersen

I'm 80, have stage 4 lung cancer and COPD (chronic obstructive pulmonary disease) and have been in and out of the hospital during the past year. I live alone. I'm not sure when I'm going to die, but things aren't looking so good. As a journalist by training, when in doubt, I consult an expert. So, I've hired Kristin, a death doula, to help me navigate the complexities of death and dying.
"I've always been a strong-willed person — some would say a control freak. I am determined not to die on someone else's terms."I found Kristin — where else — on the internet. She's a former hospice social worker who goes to doctor's appointments with me and serves as my health care proxy and end of life therapist. She supports me when it comes to medical interventions I don't want. Once I can't do the things I love, like swimming, eating out with friends, book clubs, movies and discussion groups, she'll help me find a way to die. She swears she will make sure I don't die in a hospital.
She's a former hospice social worker who goes to doctor's appointments with me and serves as my health care proxy and end of life therapist.
Since I'm a journalist, I asked her why she chose such a seemingly grim profession. She said, "I became a death doula for the purely selfish reason that being part of a beautiful dying experience is a joy. To help a family reunite, to relieve the fear of dying, to watch a dying person find a peaceful acceptance, and even a curious wonder of the next place beyond this earthly life is an amazing spiritual experience for me as well."  
I've always been a strong-willed person — some would say a control freak. I am determined not to die on someone else's terms. My recent hospital stay — which resembled a horror movie complete with the noise of bedlam, sadistic nurses, nonsensical rules and no way to escape — convinced me of that. So did the death of my closest friend, Lonnie.
The Wake-up Call of a Friend's Death 
Lonnie was 79 when she died last year. She had been diagnosed with metastatic cancer but was determined to fight it as long as possible, a noble goal. She did pretty well for 5 years, going through every grueling chemo treatment uncomplainingly, but the disease finally took over. She was in a lot of pain but refused to give up.
When I suggested she go into hospice, she was horrified. "But that means I'm going to die. I don't want to die." I should have had the guts to say, "But you are going to die, we all are."
I just couldn't.
I will never forget our chilling final phone call where Lonnie said to me, in an agonized, panicky voice I'd never heard from her before, "Erica, this is a nightmare, an absolute nightmare." I felt so helpless. I couldn't imagine what she was going through.
Overcoming denial of death takes even more courage than fighting fruitlessly to stay alive. 
Lonnie belied the whole "valiantly fighting cancer" trope. Why don't we admire people who valiantly decide to stop fighting cancer? Overcoming denial of death takes even more courage than fighting fruitlessly to stay alive. 
Her death was my wake-up call. I determined I was not going to follow her path.
No Longer Beating the Odds
Not that I was a paragon of preparation for death. I didn't have an advance directive or health care proxy or even a last will and testament until recently. When I got lung cancer at 76, I took the latest "targeted therapy" until the side effects became unbearable. Then I got radiation. I managed to keep cancer at bay for four years. I was in denial about the deadliness of my diagnosis. I was sure I would beat the odds. 
Until I didn't.
Before antibiotics they used to call pneumonia "the old man's friend" because it killed you quickly and painlessly. I was gasping for breath when a friend called 911. I was hospitalized with pneumonia caused by a staph infection, pumped full of antibiotics and kept alive. 
No one asked me if I wanted treatment, but when you're gasping for breath, you don't say no to oxygen. I came out of the hospital with my right lung filled with malignant fluid, barely able to breathe, and had to have yet another surgery.
The unconscious assumption is that if you keep moving, maybe you won't die.
At this point my death doula is helping me decide whether it's worth it to take more chemo to fend off cancer for a few more years, simultaneously battling COPD, or just live my best life as long as possible. The verdict isn't in yet.
Denial of death is a lifestyle in America. Studies show that that people over 75, no matter their physical health, consider themselves healthy as long as they're still social and active. Poor physical functioning plays a less important role in their health self-estimate, even though the majority of older adults have two or more chronic illnesses.
The unconscious assumption is that if you keep moving, maybe you won't die. My friends keep relentlessly busy — traveling the world, taking classes, exercising, volunteering, going to museums, concerts and other events. Yes, they have ailments that they kvetch about, but it doesn't stop them. This is the American way of aging — keep going at all costs — preferably to an exotic location. 
Dying is something that's supposed to happen to someone else, not you. I understand the impulse to be "positive" and celebrate octogenarians like Jane Fonda or Nancy Pelosi. I envy people who lead active lives into their 90s then die in their sleep or after a short illness, like Stephen Sondheim or Betty White.   
Few Role Models for Dying 
But how about the rest of us who are destined to die slow and painful deaths partly abetted by the miracles of modern medicine? We all have horror stories. Many of us saw our parents' lives painfully and artificially prolonged. Those horror stories persist because the medical machine will grind on unless someone stops it. 
I will try to face my death without fear, but hey, I'm human and it's scary stuff — especially since I'm not sure about the afterlife. 
What happens when you can't be active and social anymore and poor physical functioning takes over? How do you "think positive" when facing the grim reaper? Who do you turn to then?
We have few role models for dying. Some celebrities who lived in the limelight die in the dark. Barbara Walters retreated from public life in her 80s due to ill health and just died at 93. I wish I knew what she was doing for the past 10 years. Walters was a courageous woman, maybe she faced those years with grace and courage. We'll never know.
I will try to face my death without fear, but hey, I'm human and it's scary stuff — especially since I'm not sure about the afterlife. 
I used to admire Dylan Thomas' fierceness about not succumbing to death. But only a young man could have written "rage, rage against the dying of the light." Now that I'm old, I prefer to "go gentle into that good night."


I'm a Solo Ager and I've Hired a Death Doula

When I had to reschedule my routine colonoscopy from March of this year to the next available date in July, I'd already had to reprogram it twice due to the pandemic and a change in my doctor's schedule. However, in March, it was because I didn't have someone I knew to sign me out when I left the hospital.
"Cab and ride-share drivers can't sign you out because if you're placed under anesthesia, they must also declare they will stay with you for 24 hours. It's in the patient's best interest but is a troubling barrier."When I became widowed in 2018, one thing I didn't think of was no longer having a family member to take me home when I had outpatient medical procedures. Immediately upon setting my appointment, the registrar told me that because they had to put me under anesthesia, I'd have to have someone I know check me out and take me home.
I thought of asking another friend, but she would have to take precious vacation time from work.
I found a retired friend to go with me, but her dog became critically ill, and she couldn't leave her. So I called the doctor's office and asked if I could call a ride-share. She told me I couldn't, that they would only release me to someone I know or to medical transport.
Hence, I asked if they knew of any transports; she only knew of costly companies specializing in emergency medical transport. I thought of asking another friend, but she would have to take precious vacation time from work. So I finally gave up and reset my appointment.
A Pew Research Study showed in 2019 that 28% of adults 50-64 don't have partners, and 36% of those 65 and older are unmarried or in a committed relationship (combine that with many older adults having no children, being estranged from children, or living far away from them).
Indeed, many individuals struggle with finding rides to and from doctor appointments and procedures.
"This is a significant issue," says Ailene Gerhardt, an independent Board Certified Patient Advocate (BCPA) for Beacon Patient Solutions, LLC in Brookline, Massachusetts. "Cab and ride-share drivers can't sign you out because if you're placed under anesthesia, they must also declare they will stay with you for 24 hours. It's in the patient's best interest but is a troubling barrier." 
"The data is anecdotal, but this issue affects health outcomes for people who don't have family or friends who can provide a ride because they will skip the screenings and procedures they may need."
Changes in Culture Contribute to People Needing More Help from Non-Family Members
Sharon Geltner, a nonprofit specialist for Froogle PR in Boyden Beach, Florida, notes the issue of finding rides to and from medical procedures has always been present. Still, many societal changes over the past two to three generations have exacerbated the situation. 
"Families are more spread out today, and many don't live in multi-generational households," says Geltner. "Also, we don't do things as a community as we once did, like joining clubs or even participating in religious activities." 
As a result, she says, people don't have community social support. She also notes the isolation of the pandemic in recent years hasn't helped.
Service and Nonprofit Organizations Can Help
If you're having issues finding transportation to and from medical procedures, Gerhardt says not to look to your doctor's office for help. "I know of some doctor's offices that had granted to hire professional social workers as discharge planners, but most of those grants dried up. So many people in medical offices or hospitals don't know what resources exist."
Gerhardt tells some government agencies can help, such as local Area Agency on Aging offices and some nonprofits. "The problem is most government agencies don't communicate their services effectively, and many nonprofits don't know how to spread the word," says Gerhardt.
Judy Light is the volunteer coordinator for Kindness, Inc., an organization in Mountain Home, Arkansas, that provides rides to and from doctor's appointments and medical procedures. 
The 25-year-old organization also offered rides to pick up groceries, but the pandemic weakened the volunteer pool from approximately 40 volunteers to 25, and they had to suspend that service.
"We've been around for 25 years, and I say we're still the best-kept secret in Mountain Home," says Light, who adds they try to get the word out through local media outlets, social media, and fundraisers. In addition, the organization provides between 20-25 rides per week at no cost. 
She recognizes the need for the service, not only for others but possibly for herself in the future.
Light says the service is critical in an area where many people have come to retire and have no family who lives close by.
Phyllis Tucker, a Mountain Home resident, has been using Kindness services since 2018. The 83-year-old has family about an hour away but says her son and grandson work and aren't always available when she needs them. 
"I wouldn't be able to get to my doctor's appointments if it weren't for Kindness," says Tucker, adding she befriended one of the volunteers who also takes her to church and still takes her for her grocery shopping.
My friend, Jeanie Feltman, 71, who took me for my colonoscopy (I had to travel to another city not serviced by Kindness), has been volunteering for the organization for six years. 
She recognizes the need for the service, not only for others but possibly for herself in the future. "I will do it as long as I can, I enjoy it, and I may need it one day," Feltman says.
Tips on Finding Rides 
Make a plan. Gerhardt says advance care planning usually doesn't include thinking of who can take you to routine medical or minor procedure medical appointments. "Ask yourself who in your life can take you and make a note of them, as well as backups," says Geltner. These people may include extended family, friends, people from your religious community, or other groups.Consult local agencies and organizations. Geltner says Area Agencies on Aging locations may know of resources available in your community. Or go directly to the Eldercare Locator, a federal government resource guide or call 1-800-677-1116 to find help in your area. 

Transportation To Medical Appointments Can Be Tricky For Solo Agers

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